Leslie Alex Konkin, M.D., Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

G24534 Issued in CA

Legal business name

LESLIE ALEX KONKIN, M.D., INC.

Practice address

1501 Oakdale Rd Ste 301
Modesto, CA 95355-3382

Phone

(209) 571-5071

Fax

(209) 577-1157

NPI assigned

Aug 14, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Leslie Alex Konkin, M.D.

Title

Owner-President

Phone

(209) 571-5071

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413504000000",
    "number": "1427061993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576158",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953576158",
            "telephone_number": "209-571-5071",
            "fax_number": "209-577-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 OAKDALE RD STE 301",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553382",
            "telephone_number": "209-571-5071",
            "fax_number": "209-577-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LESLIE ALEX KONKIN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2014-10-17",
        "status": "A",
        "authorized_official_last_name": "KONKIN",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "ALEX",
        "authorized_official_title_or_position": "OWNER-PRESIDENT",
        "authorized_official_telephone_number": "209-571-5071",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "G24534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "ZZZ06639Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9703018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dmitry Leonov, PHRAM.D.
• Denisse Lepe
• Laura Lepe
• Malia Lepe
• Summer Leshko
• Angela Lev, RN
• Jeffrey Rubin Levin, MD
• Robert Lee Levy, MD
• Jennifer Lew-Vang, RD
• Antonisha Lewis

• Orthopaedic Surgery Physician in Modesto, CA
• Providers in Modesto, CA by specialty
• Orthopaedic Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.